Induction of labour (IOL) is an obstetric procedure that should be conducted in a healthcare facility with the capacity to provide optimal care based on the patient risk status. Inadequate monitoring, untimely procedure and lack of readily available and experienced medical staff to participate in the care of the patient undergoing induction are hazardous with snowball effects.
A 38-year-old G4P2+1 had IOL because of oligohydramnios at term in a district hospital. The procedure was inadequately monitored and fetal demise occurred. The duration of second stage was prolonged and sequential use of vacuum and forceps deliveries were unsuccessfully performed.
At the ensuing caesarean delivery, uterine rupture/tear was diagnosed, and the patient died due to haemorrhage during an emergency hysterectomy.
This report highlights important clinical lessons on IOL in a high-risk pregnancy. The timelines for monitoring during IOL, particularly when there is fetal demise in labour, are proposed.
This report highlights important clinical lessons on IOL in a high-risk pregnancy. The timelines for monitoring during IOL, particularly when there is fetal demise in labour, are proposed.Caesarean Section (CS) is a mode of delivery to decrease maternal and perinatal morbidity and mortality. We aimed to determine the type of anaesthesia used for CS among live-birth deliveries; and the failure rate of spinal anaesthesia (SA) in Princess Marina Referral Hospital, Botswana.
Women who underwent CS from May-December 2017 were enrolled in the study. Data were recorded from anaesthesia charts and abstracted using Excel spreadsheet. We established the type of anaesthesia used, comparing the rate of elective versus emergency indications, and failure rate of SA using STATA. Fisher's exact test used to compare results.
Among 2775 live-birth deliveries, 30.2% (837/2775) was by CS. Of those, 95.2% (797/837) had had SA and 4.8% (40/837) were GA. Under SA, 27.4% (218/797) were elective, and 72.6% (579/797) were emergency. Under GA 10% (4/40) were elective and 90.0% (36/40) were emergency. The overall failure rate of SA was 2% (16/813), that is 0.9% (2/220) for elective and 2.4% (14/593) among emergency indications; Fisher's exact test p = 0.2959.
Our study demonstrated that single shot SA is the most commonly preferred type of anaesthesia for both elective and emergency CS. The overall failure rate of SA was less common in our settings than previously reported.
Our study demonstrated that single shot SA is the most commonly preferred type of anaesthesia for both elective and emergency CS. The overall failure rate of SA was less common in our settings than previously reported.Adverse childhood experiences are a factor that may cause physical illness and deterioration of lifelong well-being in addition to many mental and psychiatric problems in the future. It is important to question and treat them.
This study examined the effects of adverse childhood experiences on pregnancy-related anxiety and acceptance of motherhood role.
This cross-sectional study was conducted on 536 pregnant women. The data were collected using the "Personal Information Form", the "Adverse Childhood Experience Questionnaire (ACEQ)", the "Acceptance of Motherhood Role (AoMR)" subscale of the "Prenatal Self Evaluation Questionnaire (PSEQ)" and the "Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2)".
It was found that those with high levels of negative childhood experience had higher levels of anxiety in pregnancy and lower acceptance of maternal role than the other groups (p&lt;0.05). Additionally, a one-unit change in the AoMR score led to a 0.23-unit decrease in the ACEQ score, whereas a one-unit change in the PRAQ-R2 score led to a 0.57-unit increase in the ACEQ score (p&lt;0.001).
Adverse childhood events increase pregnancy-related anxiety and negatively affect acceptance of motherhood role.
Adverse childhood events increase pregnancy-related anxiety and negatively affect acceptance of motherhood role.Despite the lack of adequate studies on the safety of drugs in pregnancy, surprisingly, available evidence shows that pregnant women still take large number of drugs.
The study aim was to determine drug utilization pattern and predictors of number of medications used by pregnant women.
This was a cross-sectional survey of 369 pregnant women attending a secondary health facility. Data were collected using interviewer-administered questionnaire. Descriptive and inferential statistics using the Chi-Square test were carried out with level of significance set at p&lt;0.05.
Three hundred and sixty-nine women were interviewed. Their mean age was 27.7 years (SD± 4.78) and the mean number of pregnancies was 2.46 (SD± 1.34). On average, 2.62 medications were taken, with the lowest being 1 and the highest being 12 different medications during the course of pregnancy. Those who were on more than 2 medications were more likely to be older than 30 years, had lower education and with history of associated medical conditions. All participants were on one form of supplements or the other, nearly half had used antimalarials, 12.8%, 5.8% 2.4% were on antibiotics, anti-hypertensive and anti-retroviral medications respectively. All the medications prescribed were from category A, B, C, N, and none from category D and X.
Varieties of medications were used during the course of pregnancy among this population, however, most of these drugs were still within safety profile.
Varieties of medications were used during the course of pregnancy among this population, however, most of these drugs were still within safety profile.Gender inequality is a pervasive problem in sub-Saharan Africa, and has negative effects on health and development.
Here, we sought to identify socioeconomic predictors of gender inequality (measured by low decision-making power and high acceptance of intimate partner violence) within heterosexual couples expecting a child in south-central Uganda.
We used data from a two-arm cluster randomized controlled HIV self-testing intervention trial conducted in three antenatal clinics in south-central Uganda among 1,618 enrolled women and 1,198 male partners. https://www.selleckchem.com/products/Nicotinamide(Niacinamide).html Analysis included Cochran Mantel-Haenzel, proportional odds models, logistic regression, and generalized linear mixed model framework to account for site-level clustering.
Overall, we found that 31.1% of men had high acceptance of IPV, and 15.9% of women had low decision-making power. We found religion, education, HIV status, age, and marital status to significantly predict gender equality. Specifically, we observed lower gender equality among Catholics, those with lower education, those who were married, HIV positive women, and older women.